Individual
BONNIE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
76 STEPHENVILLE BLVD, RED BANK, NJ 07701-6249
(908) 902-0481
Mailing address
PO BOX 144, RED BANK, NJ 07701-0144
(732) 788-6146
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05857100
NJ
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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